Health Crisis: Now, Action

The problem of California’s 7 million people without health insurance has been talked to death. In a nutshell: Americans 65 and older receive health care through the federal Medicare program. Other government programs including Medicaid--known in California as Medi-Cal--and Healthy Families cover the very poor and disabled and some children from working families. Left out are the working poor themselves. Eight in 10 Californians without insurance have jobs or come from families with at least one person employed but earn too little to buy insurance and too much to qualify for government programs. A new set of possible solutions is on the table and shouldn’t be shelved without action.

A year ago the state health department called for new ideas for providing health care to the one in four Californians who has no coverage. Health-care advocacy groups and professors from UCLA, UC San Diego, UC Berkeley and UC San Francisco proposed remedies. A series of statewide public hearings on nine proposals ended Friday in Sacramento.

The Health Care Options Project tells us there is a way--there are at least nine ways--to expand health care coverage. The project directors will submit their report to the Legislature and the governor next month.

Our elected officials should resist the easy path of clucking sympathetically and then leaving the report to gather dust. The problem can’t be fixed all at once, but as the federally assisted Healthy Families program has shown, fixing it is not impossible.

Some of the proposed reforms would tweak programs already in place. Proportionally, California is last among the states in the number of residents with job-based health insurance, and one plan would increase incentives to small employers to offer health insurance. Another, already introduced as Assembly Bill 32, by Assemblyman Keith Richman (R-Northridge) and Sen. Liz Figueroa (D-Fremont), would combine and expand the existing Healthy Families and the Medi-Cal programs. Three call for major overhauls that would provide universal coverage under a single-payer system.

Fixing the health care system is going to cost money, but not fixing it also has costs. Somebody pays when people without insurance seek help. Hospitals with already strained profit margins are forced to eat expenses. Emergency rooms shut down, putting insured and uninsured alike at risk. Costs get passed on through higher insurance premiums. The risk from infectious diseases rises.

We don’t know which proposal or which combination of these would work best. What we do know is that California can do better than leaving millions of its working-poor families without health care coverage.